Fracture, Healing, and Medical Pluralism: A Medical Anthropological Comparison of Western Biomedicine, Traditional Chinese Medicine, and Dai Medicine

Abstract

A broken bone in southwestern China can be seen and treated through three medical systems: Western biomedicine, Traditional Chinese Medicine (TCM) and Dai medicine. Each has their own story of injury and healing. The paper takes fracture treatment as a case study of medical pluralism and compares the three systems in explaining, diagnosing and treating fractures, and in the movement of patients among them. Based on the explanatory model in medical anthropology, individual case studies, hospital fieldwork at Xishuangbanna Lin Yanfang Ethnic Hospital and literature. The paper argues that the systems provide differing, and sometimes incommensurable, readings of fracture: biomedical, as vascular and tissue disruption; TCM, as Qi-blood stagnation; and Dai medicine, as elemental or ‘cold’ imbalance. In practice, however, they often coexist rather than act alone. Hospitals that include biomedical, TCM, and Dai clinics, as well as cases in which TCM bone-setting is combined with surgical fixation, are examples of what medical anthropology calls ‘interpenetrative pluralism’. But that pluralism isn’t symmetrical. Patients generally first encounter biomedicine and then turn to traditional systems because of cost, trust, cultural familiarity, and a practitioner’s reputation. Fracture care illustrates how bodily injuries are interpreted through culturally situated ideas about the body, institutional histories, and unequal forms of medical legitimacy.